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Workers’ Compensation
Court of Appeals
July through September 2006
Case summaries published are
those prepared by the WCCA
Substantial evidence, including medical records, the employee’s testimony and expert medical
opinion, supports the compensation judge’s finding that the employee sustained a Gillette injury in
the form of bilateral carpal tunnel syndrome.
Substantial evidence, including medical records and the employee’s testimony, supports the
compensation judge’s finding that the employer had adequate notice of the employee’s Gillette injury
in the form of bilateral carpal tunnel syndrome.
Affirmed.
Substantial evidence, in the form of a well-founded medical opinion, exists to support the
compensation judge’s decision that the employee’s work injuries are substantial contributing factors
in his need for knee replacement surgery.
Affirmed.
Wages – Irregular
Where the employee’s weekly wage was irregular, ranging from $225.60 to $1,304.49 over the
course of the 23 weekly pay periods preceding her work injury, and where the employee earned less
than $1,000 during 15 of those 23 pay periods, the compensation judge’s decision not to exclude the
Summaries of Decisions
two lowest weekly pay-periods from her computation of the employee’s average weekly wage was
not clearly erroneous and unsupported by substantial evidence.
Wages – Bonus
Where the employee’s weekly wage over the course of the 26 weeks prior to her work injury had
been irregular, where she had received a $3,000 signing bonus and a $600 Christmas bonus during
that period, where the Christmas bonus was based in part on regular attendance at work over the
course of the preceding year and so was related to the employee’s individual performance, and where
the signing bonus was unrelated to the employee’s individual performance, the compensation judge’s
decision to include the Christmas bonus pro-rated over the course of the entire year rather than only
the half-year averaging period was not clearly erroneous or unsupported by substantial evidence, but
the judge’s inclusion of the signing bonus was clearly erroneous.
Appeals – Record
Vacation of the compensation judge’s order for dismissal is required where the judge made no
findings on factual issues and there was no record of the proceedings leading to the dismissal.
Substantial evidence, including the well-founded opinion of the employer and insurer’s medical
expert, supports the compensation judge’s determination that the employee’s work activities as a
cashier were not a substantial contributing cause of her carpal tunnel syndrome.
Affirmed.
Causation
Although the compensation judge erroneously found the evidence failed to show the employee’s
treating doctors understood the employee had been diagnosed with carpal tunnel syndrome in 1996,
there is substantial evidence, including the adequately founded opinion of the independent medical
examiner, to support the finding that the employee failed to prove that her work activities for the
employer were a substantial contributing cause to the development of bilateral carpal tunnel
syndrome.
Affirmed as modified.
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Summaries of Decisions
Causation
Substantial evidence, including expert medical opinion, supports the compensation judge’s findings
that the employee’s January 2004 injury was a substantial contributing factor in her cervical, thoracic
and lumbar spine injuries.
Substantial evidence, including expert medical opinion and medical records, support the
compensation judge’s finding that the employee had met the requirements for additional permanent
partial disability for the thoracic spine under Minnesota Rules part 5223.0380, subps. 2(A)(2) and
3(B), as well as permanent partial disability ratings for the cervical and lumbar spine under
Minnesota Rules part 5223.0370, subp. 3(B), and Minnesota Rules part 5223.0390, subp. 3(B).
Where there was substantial evidence, including expert medical opinion, that the employee was
unable to work for a period of time, the compensation judge did not err by not addressing the issue
of whether the employee had conducted an adequate job search any time during that period or by
awarding temporary total disability benefits. Substantial evidence also supports the compensation
judge’s finding that the employee had not reached maximum medical improvement.
Substantial evidence supports the compensation judge’s finding that the employee’s medical
treatment was reasonable, necessary and causally related to the employee’s work injury.
Where the employer and insurer had denied liability for the cervical and lumbar spine injuries and
denied medical causation for treatment of the thoracic spine beyond the compression fracture, the
medical treatment parameters are not applicable.
Dr. Mark Agre’s review of the employee’s physical therapy progress does not constitute an
unauthorized change of treating physician and the employer and insurer cannot avoid paying for his
services on this basis.
Medical intervenors are not precluded from reimbursement for failure to appear at hearing where the
documentation submitted by the intervenors is sufficient to establish their claims.
Rehabilitation – Eligibility
Where the employee has restrictions due to her work-related injuries as well as due to a seizure
condition that is unrelated to her work injuries, is working in a different job than she held at the time
of injury and may be physically unable to perform the tasks of her current job on an indefinite basis,
substantial evidence supports the compensation judge’s finding that the employee is qualified for
rehabilitation assistance.
Affirmed.
Where the medical record was notably complex, where the judge clearly referenced specific elements
of the expert testimony on which she relied in finding no medical causation, where absent medical
causation there was no reason for the judge to have cited or applied any law regarding consequential
injury and where there was no reason to presume that the judge had erroneously applied the
overruled Reese standard of proof for Gillette-type injuries, there was no basis for remanding the
case to the compensation judge for fuller findings or application of other law.
Causation
Evidence – Expert Medical Opinion
Where the expert on whose opinion the judge relied was board certified, had examined the employee
on two separate occasions, and at each examination had obtained a history from the employee, had
reviewed the relevant medical records and had performed a physical examination, the expert medical
opinion on which the compensation judge relied was not without proper foundation and the judge’s
decision based on that opinion was not clearly erroneous and unsupported by substantial evidence,
notwithstanding the fact that the opinion may not have been elicited in response to a hypothetical
question.
Affirmed.
Temporary Benefits
Where the compensation judge’s findings were detailed and his memorandum substantial, where the
medical records were complex and exhaustive, where the judge cited several specific details from the
opinions of medical experts whose conclusion differed from his, there was no evidence that the
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Summaries of Decisions
judge’s review of the evidence had been insufficiently thorough so as to warrant remand for
reconsideration of his denial of the employee’s claim for wage-replacement benefits, particularly in
light of the employee’s repeatedly normal EMGs and repeatedly almost normal findings on physical
examination both before and after the period of her claim.
An employer’s initial admission of liability for an alleged work injury to the extent of agreeing to
pay for immediately subsequent medical treatment or wage replacement does not necessarily
constitute a permanent admission of liability with regard to permanency benefits. Where the
employer had paid medical and wage-replacement benefits for an admitted 1993 carpal tunnel injury,
including the cost of surgery, and where the compensation judge in denying wage-replacement
benefits for a 1997 and a 2003 work injury had relied on a medical opinion that the employee’s care
throughout the case had been excessive or unnecessary, it was not a breach of discretion for the
compensation judge to find the issue of permanency for the 1993 carpal tunnel injury insufficiently
pled and litigated in light of the fact that the employee had not listed a 1993 date of injury on her
claim petition – notwithstanding that the petition had sought permanency benefits for an unspecified
carpal tunnel injury and medical records in evidence clearly indicated that employee’s only carpal
tunnel injury was the 1993 injury.
Affirmed.
Substantial evidence, including expert opinion, supported the compensation judge’s decision that the
employee’s work injury was only temporary and did not contribute to the employee’s disability or
need for treatment for the period at issue.
Affirmed.
Apportionment – Equitable
Jurisdiction – Out-of-state Injury
Because the compensation judge erred by including a Texas work injury in her equitable
apportionment of responsibility for wage loss and medical expense benefits, remand was required to
allow apportionment between the two liable Minnesota employers.
Apportionment – Equitable
Apportionment – Permanent Partial Disability
The compensation judge erred in equitably apportioning responsibility for the employee’s permanent
partial disability to a Texas employer; the issue was whether the employee’s Minnesota work injury
was a substantial contributing cause of the claimed additional permanent impairment.
While differing inferences could be drawn, substantial evidence supports the compensation judge’s
finding that the employee’s retirement and withdrawal from the labor market was involuntary. The
critical factor in determining entitlement to permanent total disability benefits is not the employee’s
disability status at retirement, but whether the retirement or withdrawal from the labor market was
voluntary or involuntary, and the compensation judge properly awarded permanent total benefits on
these facts.
Affirmed.
Where the employee’s work-related eye condition clearly rendered the employee more vulnerable to
re-injury by a blunt blow, and where the episode at home that triggered the employee’s need for
surgery – walking into a door jamb in the dark – was not a consequence of “unreasonable, negligent,
dangerous or abnormal activity on the part of the employee,” the compensation judge’s conclusion
that the employee’s need for surgery was “a natural consequence flowing from the primary injury”
and not the product of a superseding, intervening cause was not clearly erroneous and unsupported
by substantial evidence, although the employee’s permanently weakened condition did not cause the
injuring incident at home.
Affirmed.
Substantial evidence supported the compensation judge’s finding that the employee refused gainful
employment he could do in his physical condition, entitling the employer and insurer to discontinue
temporary total disability compensation pursuant to Minnesota Statutes §176.101, subd. 1(i).
Affirmed.
Wages – Contract
Wages – Board and Allowances
Where there was little significance in the fact that the employee’s employment contract was
unwritten, and where there was testimony and other evidence to reasonably support the judge’s
findings, the compensation judge’s implicit conclusion that the employee’s per diem allowance was
part of his wage contract and should be included in calculation of his weekly wage was not clearly
erroneous and unsupported by substantial evidence.
Affirmed.
Wages – Calculation
Under the circumstances of this case, the compensation judge properly concluded that the
employee’s weekly wage on the date of injury should be calculated with reference to the two weeks
the employee worked full time prior to the injury, rather than by averaging the employee’s earnings
in part-time employment in the 26-week pre-injury period, where there was no evidence that the
employee’s change from part-time to full-time work was expected to be temporary.
The compensation judge properly concluded that the employee was entitled to treatment with the
provider she chose as her primary health care provider following her work injury, where she
subsequently treated at a different clinic, of the employer’s choice, only because the employer
refused to authorize payment to the employee’s chosen provider.
Rehabilitation – Eligibility
Where the employee was almost a year post-injury at the time of hearing, was not performing her
usual pre-injury job duties and was only working half the hours, or fewer, than she had worked prior
to her injury, the compensation judge did not err in finding the employee eligible for rehabilitation
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Summaries of Decisions
assistance, even though there was no express medical evidence that the employee was likely to be
permanently precluded from returning to her pre-injury occupation.
Affirmed.
Where there has been a change in the employee’s diagnosis, more extensive medical treatment than
anticipated, entitlement to additional permanent partial disability and a causal relationship between
the employee’s work injury and his worsened condition, none of which was reasonably anticipated at
the time of the award on stipulation, the employee has experienced a substantial change in condition
since an award on stipulation in 2002, and the employee’s petition to vacate the award is granted.
Rehabilitation – Retraining
Practice and Procedure – Statute of Limitation
Minnesota Statutes §176.102, subd. 11(c)
Where the employee made a number of filings, which raised the issue of retraining and which
resulted in contested administrative conferences, the employee made a request for retraining that
tolled the limitation period set out in the statute.
Affirmed.
An employer and insurer that have settled all future claims by the employee for a lump sum are not
entitled to lump-sum contribution or reimbursement toward that payment from a nonsettling
employer and insurer.
Where the employee was involved a motor-vehicle accident as a passenger, which resulted in the
need for additional surgery on the site of his earlier work-related fusion surgery, substantial evidence
supports the compensation judge’s finding that the accident was not a superseding, intervening cause
that resulted from conduct by the employee which was unreasonable, negligent, dangerous or
abnormal. That finding, however, did not compel a finding that the employee’s work injury remained
a substantial contributing cause of the employee’s need for surgery in 2005, unless the medical
evidence indicated that a causal relationship existed.
The issue in intervening cause cases is not merely whether the intervening injury or condition is
itself a substantial contributing cause of the employee’s subsequent disability but whether that
intervening injury or condition has broken the causal connection between the employee’s work
injury and that disability. In this case, substantial evidence, including expert medical opinion,
supports the compensation judge’s finding that the employee’s work injury was not a substantial
contributing cause of the employee’s need for additional surgery after the motor-vehicle accident.
Affirmed.
Where there was no showing that both parties had misapprehended a fact material to the proposed
settlement, the employer and insurer did not establish good cause to vacate the award on stipulation
covering the employee’s permanent total disability claim.
Where a notice of hearing was sent by the Office of Administrative Hearings to the insurer at an
incorrect address and the insurer did not receive the notice and failed to appear at the hearing, the
Findings and Order of the compensation judge are vacated and the case remanded to the
compensation judge for a hearing on the merits of the employee’s medical request.
Where it was clear from the judge’s specific findings that he was familiar with the legal standards
established in case law, where it was not unreasonable for the judge to find, based on his findings
pursuant to those standards, that the expenses at issue were not reasonable, necessary and causally
related to the work injury, and where the judge’s decision was also reasonably supported by expert
medical records and opinion, the compensation judge’s denial of payment of the chiropractic
expenses at issue was not clearly erroneous and unsupported by substantial evidence,
notwithstanding the fact that the judge did not specifically cite the case law containing the legal
standards that he applied.
Where medical as well as chiropractic bills were clearly at issue at the hearing but the judge
addressed specifically only the chiropractic treatment, the judge’s reference in his findings to his
“conclusion that the employee’s current low back problems are not substantially related to the 1987
work injury” was read to be a reference not just to the employee’s need for chiropractic care but also
to his need for medical care, and the judge’s ultimate denial of all “claims of the employee,” medical
as well as chiropractic, was not clearly erroneous and unsupported by substantial evidence and did
not require remand for further findings and reconsideration.
Affirmed.
Substantial evidence, including adequately founded expert opinion, supports the compensation
judge’s finding that the employee’s elbow surgery was not reasonable and necessary to cure or
relieve the effects of the employee’s work-related injury.
Where the employee did not have a reasonable expectation of returning to work for the employer in
the near future and a job search would not have been futile on the basis of pending surgery, and
where the employee’s short term job search attempts were limited, the compensation judge could
reasonably conclude that the job search was not diligent and deny temporary total disability benefits
on that basis.
Affirmed.
The record does not establish that the employee’s medical or psychiatric condition has substantially
improved so as to justify vacation of the compensation judge’s 1994 decision that the employee is
permanently and totally disabled as a result of her work injury.
Causation
Substantial evidence supports the compensation judge’s findings that the employee sustained Gillette
injuries in the nature of a lumbar pain syndrome and bilateral carpal tunnel syndrome on or about
Oct. 8, 2002.
Substantial evidence supports the compensation judge’s determination that the employee’s work
activities for the employer Aqua Dynamics during the period of Acuity Group’s coverage, including
the last several weeks on the Owatonna project, permanently aggravated and were a substantial
contributing cause of his lumbar pain syndrome and bilateral carpal tunnel syndrome.
Substantial evidence supports the compensation judge’s award of a 3.5 percent permanency for the
employee’s lumbar pain syndrome and the judge’s finding that the employee had not yet reached
maximum medical improvement for his low back and hand and wrist conditions.
Affirmed.
The compensation judge erred in failing to analyze the facts of this case in light of the applicable
independent contractor rules and erred in concluding that the employee’s past status as an
independent contractor meant that the employee was an independent contractor on the date of his
injury.
Where the employee, a pastor jointly employed by two small churches, was injured in an automobile
accident going home from an evening service at one of the churches, and where the employee’s
vehicle, although needed to get to and from worksites was not an integral part of the performance of
his pastoral duties, the exception to the coming and going rule in Gilbert v. Gilbert v. Star Tribune/
Cowles Media, 148 N.W.2d 114, 46 W.C.D. 188 (Minn. 1992), does not apply and the compensation
judge properly held the accident did not arise out of and in the course of employment.
Affirmed.
Substantial evidence supports the compensation judge’s denial of permanent partial disability for
bladder dysfunction and alleged nerve root injury.
Substantial evidence supports the compensation judge’s denial of the QRC’s bill for services on the
basis that the services provided were not reasonable or necessary.
Affirmed.
Whether or not the employee was intoxicated at the time of his death in an automobile accident, and
whether or not the employee had violated an express prohibition against working while intoxicated,
the purported intoxication was not the proximate cause of his death, so as to bar compensation,
where the employee was merely a passenger in the car at the time of the collision, where the
compensation judge reasonably concluded that it had not been established that the employee was
aware that the driver was intoxicated, and where the compensation judge reasonably concluded that
the collision might well have been due to the driver’s negligence as opposed to her intoxication.
Affirmed.
Substantial evidence, including expert medical opinion and medical records, supports the
compensation judge’s finding that the employee’s work-related injury to his upper extremities did
not result in his current psychological condition.
Affirmed.
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Summaries of Decisions
Where the compensation judge’s decision on primary liability and/or causation was apparently based
on an erroneous interpretation of the medical evidence and the employee’s testimony, remand for
reconsideration was required.
Where the compensation judge could reasonably conclude that the employee’s work activities for the
employer and insurer did not substantially contribute to the employee’s disability, the judge did not
err in denying the employee’s claim of a Gillette injury arising out of the employment with this
employer.
Affirmed.
Employment Relationship
Substantial evidence supports the compensation judge’s determination that the project management
company was the employer of a maintenance man for a condominium association.
Affirmed.
Substantial evidence supports the compensation judge’s finding that an inhaler was not reasonable
and necessary medical treatment for the employee’s thoracic spine condition.
Substantial evidence supports the compensation judge’s finding that claimed treatment was not for a
consequential injury and was closed out under settlement terms.
Affirmed.
Substantial evidence, including medical opinions and the employee’s testimony, supports the
compensation judge’s finding that the employee’s work activities for the employer caused her
hearing loss.
Substantial evidence supports the compensation judge’s finding that the employee’s Gillette injury
culminated on March 12, 2003, the date on which the employee’s doctor imposed work restrictions
resulting in modification of the employee’s work duties, and that the employee gave timely statutory
notice on that date.
Affirmed
Where the parties had stipulated to service of separate MMI reports in 1997, 2003 and 2006, where
there was no way to read the compensation judge’s memorandum except to conclude that the judge’s
own reasoning required dating of MMI at the 1997 service, where the latter two reports had also both
essentially dated MMI at the time of the 1997 report, where the judge offered no explanation or
contrary evidence to support her nominal finding of MMI in 2003 and where, on review, the court
found no substantial evidence conflicting with its legal conclusion or supporting the nominal but
unexplained finding of the judge, the compensation judge’s nominal finding of MMI in 2003 was
reversed and the 1997 date substituted in its place, the judge’s award of temporary total disability
benefits more than 90 days after the 1997 service was reversed and a related finding was vacated as
irrelevant.
Where it was reasonably supported by expert medical opinion and the testimony of the employee,
and where the judge expressly credited the employee’s testimony, the compensation judge’s award of
temporary partial disability benefits based on a finding that the employee remained subject to a
chronic condition consequent to her work injury was not clearly erroneous and unsupported by
substantial evidence, and the judge’s conclusion that the employee was entitled to a rehabilitation
consultation was also affirmed.
Where the employee’s work injury was clearly to her low back, where much of the treatment
awarded by the judge appeared to be to parts of her body arguably unrelated to her low back, where
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Summaries of Decisions
the parties had stipulated to the reasonableness and necessity of all treatment at issue but not to its
causal relationship to the work injury and where the employee’s entitlement to temporary partial
disability benefits was affirmed, the compensation judge’s general award of payment of all claimed
medical expenses, without any citation of the evidence on which she was relating non-low-back
treatment to the low back work injury, was remanded to the compensation judge for reconsideration
and more reviewably specific findings.
Reversed in part, vacated in part, affirmed with modification in part and remanded in part.
Appeals
Because the issue of the employee’s entitlement to reimbursement of the claimed costs related to a
previous hearing has been adjudicated and affirmed by the Minnesota Supreme Court, the employee
is precluded from claiming costs related to that same hearing.
Vacation of Award
Finding no grounds under the statute for which the previous findings and order can be vacated, we
deny the employee’s petition to vacate those findings and order.
Affirmed.
Minnesota
Supreme Court
July through September 2006
Case summaries published are
those prepared by the WCCA
Decision of the Workers’ Compensation Court of Appeals filed March 1, 2006, affirmed without
opinion.
• Lori Bengston v. Pioneer Packaging and Printing, and St. Paul Travelers, and Medica Health Plus/
Ingenix, Fairview Health Services, Novacare Rehabilitation, Noran Neurological Clinic, and Kari
Clinic of Chiropractic, Intervenors, A06-725, July 19, 2006
Decision of the Workers’ Compensation Court of Appeals filed March 14, 2006, affirmed without
opinion.
• Ronald W. Odash v. Pepsi, Inc., and Kemper Insurance Companies, and Medicare/Noridian
Administrative Services, Northstar Neurological, and Millennium Neurology, Intervenors, A06-726,
July 20, 2006
Decision of the Workers’ Compensation Court of Appeals filed March 14, 2006, affirmed without
opinion.
• Douglas Kurtz (deceased), by Dawn Gillman v. Lakes Medi Van, Inc., and State Fund Mutual
Insurance Company, and American Family Mutual Insurance Group, Intervenor, A06-952, Aug. 23,
2006
Decision of the Workers’ Compensation Court of Appeals filed April 25, 2006, affirmed without
opinion.
• Neil Prochnow v. Robert Gibb and Sons, Inc., and Cincinnati Insurance Companies, and St. Francis
Medical Center, Meritcare Hospital, Meritcare Medical Group, and United States Veterans Affairs,
Intervenors, A06-991, Aug. 23, 2006
Decision of the Workers’ Compensation Court of Appeals filed April 27, 2006, affirmed without
opinion.